A doula by the name of Anne Shirley says, "You write your birth plan when you choose your provider and place of birth." I think it is so important to repeat her words at every consultation going forward and even in our first prenatal. It happens frequently enough, when a mom who desires a natural birth finds herself in a position where, despite provision for birth, best evidence, and even support from her provider prenatally, she's being confronted with the idea that if she fails to follow a recommendation, "the baby could be in danger." Moving the labor along by adding Pitocin, or lying flat on her back in order to push her baby are among the unneeded recommendations I see all too often.
In a full-on labor it is so hard to remember whether your desire is based on your idea of a natural birth or actual evidence based research about what is best for your baby. It comes as a shock to most parents after the fact, that their provider is not obligated to practice in line with the latest research or even to follow the recommendations of the ACOG.
Culturally we are conditioned (especially as women) to mediate and avoid conflict., but principles that are in conflict inevitably become exposed sooner or later. When it comes to birth, isn't it better to find out that your practice doesn't support your desire for birth before you go into labor? An important question for mothers to consider during their prenatal OB visit is not only whether their provider can support their birth plan, but what about the rest of his/her practice? Mother's should also ask their providers whether the hospital staff where they practice are supportive of your your birth choices in general.
It is SO important moms and dads, to remember that you are indeed a consumer of health care. I typically tell my clients that you don't have to invite them to Thanksgiving dinner, and that patients switch practices is all the time- for so many different reasons. Often it's for a difference in philosophy about birth, but that is only one among reason.
If you feel anything less than 100% supported by your care provider, then the most important thing that you can do is address it. Either through a conversation about your expectations for the doctor you've hired, or simply moving to a practice more in line with your desires for birth. If you're a follow-up kind of mom, write them a letter explaining why after the fact.
Mom, you can also just say "No" when provided with an option that you don't desire. Whether it's changing from all fours to being on your side to make your provider less achey, or declining a hepatitis vaccination for your newborn child. When you are informed about the benefits and the risks of your choices you can make these decisions in conjunction with a provider rather than in spite of them.
I'm here to help you get informed about birth, and how empowering a partnership with your care provider can be. This is also why I offer to attend a prenatal appointment with you if you would find it helpful. Let's make a team that works. For your baby, and for you.